Meintjes Marius
Frisco Institute for Reproductive Medicine, Frisco, TX, USA.
Methods Mol Biol. 2012;912:107-27. doi: 10.1007/978-1-61779-971-6_8.
Most embryo culture media are still supplemented with proteins rather than with nonprotein macromolecules or recombinant protein products. HSA is probably the most common supplement followed by globulin-enriched preparations. Serum supplementation and Co-Culture of embryos belong to the past. Defined nonprotein or recombinant protein supplements are becoming a viable alternative during gamete and embryo manipulation procedures. Biological protein supplements are still preferred for any extended period of embryo culture. Understanding the goals and purpose of supplemented macromolecules in embryo culture media during each step of the laboratory IVF process should assist us in choosing the safest and most consistent macromolecule for each step, but also selecting a product that has the capability of delivering the best clinical outcome. Each batch of biological protein supplement is unique, even if supplied by the same manufacturer. Each lot of protein supplement typically contains many lot-specific, potentially harmful, and unintended hormone and protein contaminants. Macromolecular embryo culture medium supplements should be identified as one of the highest risk factors in an IVF laboratory that may contribute towards clinical compromise. All efforts should be made to use a proven batch of supplement for as long as the expiration date will allow. The beneficial effect of more complex protein supplements is evident after the activation of the embryonic genome and probably due to the presence of growth factors. Lower live-birth rates due to suboptimum protein supplementation may be a direct result of the preferential loss of female embryos. When deciding on a culture system, thought should be given specifically to the interaction between the culture medium and the macromolecular supplement. Ready-to-use pre-supplemented culture media may be advisable over a more complex product if a comprehensive macromolecular quality management program is not feasible. However, the question remains as to whether the increasing simplification of embryo culture media supplements is ready for large-scale clinical use.
大多数胚胎培养基仍添加蛋白质，而非非蛋白质大分子或重组蛋白产品。人血清白蛋白可能是最常用的添加物，其次是富含球蛋白的制剂。血清添加和胚胎共培养已成为过去式。在配子和胚胎操作过程中，明确的非蛋白质或重组蛋白添加物正成为一种可行的替代选择。在任何长时间的胚胎培养过程中，生物蛋白添加物仍是首选。了解实验室体外受精过程每个步骤中胚胎培养基中添加大分子的目标和用途，应有助于我们为每个步骤选择最安全、最稳定的大分子，同时也能选择一种有能力带来最佳临床结果的产品。即使由同一制造商提供，每一批生物蛋白添加物也是独特的。每一批蛋白添加物通常都含有许多批次特异性、潜在有害且意外的激素和蛋白质污染物。大分子胚胎培养基添加物应被视为体外受精实验室中可能导致临床结果不佳的最高风险因素之一。应尽一切努力在有效期允许的情况下使用经过验证的一批添加物。更复杂的蛋白添加物在胚胎基因组激活后其有益效果明显，这可能是由于生长因子的存在。因蛋白质添加不足导致的较低活产率可能是雌性胚胎优先损失的直接结果。在决定培养系统时，应特别考虑培养基与大分子添加物之间的相互作用。如果全面的大分子质量管理计划不可行，预添加好的即用型培养基可能比更复杂的产品更可取。然而，胚胎培养基添加物日益简化是否已准备好大规模临床应用，这一问题仍然存在。
